Parker Meiling Hua, Berghella Vincenzo, Nijjar Jugnu Biba
a Department of Obstetrics and Gynecology , Sidney Kimmel College of Medicine at Thomas Jefferson University , Philadelphia , PA , USA.
J Matern Fetal Neonatal Med. 2016;29(11):1747-50. doi: 10.3109/14767058.2015.1060214. Epub 2015 Jul 28.
To evaluate whether bariatric surgery is associated with intrauterine growth restriction (IUGR).
We performed a population-based retrospective cohort study to estimate the relationship between prior bariatric surgery and adverse pregnancy outcomes. The data were collected from the 2012 Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS). Pregnancies in obese women with a prior bariatric surgery were compared to those of obese women without. Outcomes of interest were pre-eclampsia, IUGR, intrauterine fetal demise, large for gestational age, postpartum hemorrhage, failed induction of labor, cesarean delivery and operative vaginal delivery. Multivariable logistic regression analysis was used to adjust for potential confounders.
186,605 obese women with singleton gestations were identified. Among these, 1585 (0.8%) women had a prior bariatric surgery. Prior bariatric surgery was associated with an increased risk of IUGR (5.7% versus 2.2%, adjusted odds ratio 2.89, 99% CI 1.55-5.39, p < 0.0001) even after adjusting for confounding factors. No differences were seen in our other outcomes of interest.
Singleton gestations in obese women with a prior bariatric surgery have an increased risk of IUGR. It may be reasonable screen these pregnancies for the development of growth restriction.
评估减肥手术是否与胎儿宫内生长受限（IUGR）有关。
我们进行了一项基于人群的回顾性队列研究，以估计既往减肥手术与不良妊娠结局之间的关系。数据收集自2012年医疗成本与利用项目全国住院患者样本（HCUP-NIS）。将既往接受过减肥手术的肥胖女性的妊娠情况与未接受过手术的肥胖女性进行比较。感兴趣的结局包括子痫前期、IUGR、胎儿宫内死亡、大于胎龄儿、产后出血、引产失败、剖宫产和阴道助产。采用多变量逻辑回归分析来调整潜在的混杂因素。
共识别出186,605名单胎妊娠的肥胖女性。其中，1585名（0.8%）女性既往接受过减肥手术。即使在调整混杂因素后，既往减肥手术仍与IUGR风险增加相关（5.7%对2.2%，调整后的优势比为2.89，99%可信区间为1.55-5.39，p<0.0001）。在其他感兴趣的结局方面未发现差异。
既往接受过减肥手术的肥胖女性单胎妊娠发生IUGR的风险增加。对这些妊娠进行生长受限的筛查可能是合理的。
